arsenal09490 t1_iyboubb wrote
Reply to comment by Relevant_synapse in Alzheimer’s Drug In Development, Lecanemab, May Benefit Some Patients But Carries Risks of Brain Swelling and Bleeding by Relevant_synapse
The rates of ARIA were concerning, but they were pretty localized in patients with ApoE ε4 carrier. Still high in non-carriers, but at least that has a better risk-benefit profile. Additionally, only 0.8% of ARIA cases were considered severe. That being said, the risk of ARIA leading to discontinuation will make it difficult to identify ideal candidates until more data comes out.
I do not think lecanemab should interfere with any DOACs or antiplatelets? However, patients on these medications may be at an increased risk of ARIA and/or brain bleeds (especially if the have a stroke and need tPA). So the potential additive blood thinning effect may further limit the population this drug could be used in.
Relevant_synapse OP t1_iybp4zt wrote
Did you see the reports of the two patients who had massive brain hemorrhages and died during the open label extension? One was an E4 noncarrier who was heparinized for an MI and the other was an E4 homozygote who got tPA for a stroke.
Presented here: https://twitter.com/JacobPlieth/status/1597770771606429698?s=20&t=EUU4CuKWkmzyva1QQH9d3g
arsenal09490 t1_iybpqh3 wrote
No, I have not had a chance to look at those reports yet. Are they published or just announced in the press release?
Relevant_synapse OP t1_iybq2ec wrote
Not sure about the first case. Per this article in Science Insider, the second case has at least been written up?
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